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4 weeks of pregnancy, heavy bleeding, unbearable cramping, sore back and stomach, nausea. Miscarriage? D&C?

I would have been 4 weeks pregnant today. I woke up with spotting bleeding then it got a lot heavier and cramping became unbearable. It was MUCH worse than a period. I m still bleeding but the cramping has subsided. I m sure I ve miscarried. Do I need a d&c? Tonight my back and stomach feel very sore. I feel bloated and a bit nauseated. Is this normal?
Asked On : Tue, 31 Jul 2012
Answers:  2 Views:  37
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OBGYN 's  Response
Jan 2016
Hallow Dear,

I believe when you state 4 weeks of pregnancy, it is 4 weeks after you have missed your period.

Yes, such a heavy bleeding associated with severe cramps in abdomen is most likely to be due to abortion. Usually, when there is bleeding associated with pain in lower abdomen, such pregnancies cannot be salvaged. If you have noticed any white 'clot' on your pads, the abortion is confirmed.

However, I would advice you to undergo ultrasonography. If the products of gestation are seen in the uterine cavity, it means the baby (may be completely or partially) is still present in the uterine cavity. If there are no heart beats seen in scan, then it is incomplete abortion and you need to get it completed by evacuation of the uterine cavity. If no products are seen in the uterine cavity, it means you have aborted completely and no further intervention is required.

Pregnancy test on urine will not be conclusive since these tests become negative only after more than a week after the baby has become nonviable.

Please report to your Gynaecologist ASAP to have earliest intervention before you loose substantial blood.

I hope this has guided you for your immediate action.

Dr. Nishikant Shrotri
Answered: Mon, 30 May 2016
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OBGYN Dr. Nishikant Shrotri's  Response
Jan 2016
Hallow Dear,

I am very sorry to learn that you are having considerable bleeding with pain in abdomen during early phase of your pregnancy.

Whenever there is bleeding per vaginum in the first three months of pregnancy, we label it as Threatened abortion and try to salvage the pregnancy by different means. However, when such bleeding s associated with pain in abdomen, usually, it is not possible to save such pregnancy.

If you get your ultrasonography done, you will get the information of the condition of the baby. Urine pregnancy test will not be of use at this juncture as it takes about 7-10 days for it to become negative after the baby has become non-viable.

Please use sanitary napkins and save all the pads for the inspection. If you see any white 'clot' on the pads, it is the part of the baby. Then the process of abortion has started which may have to be completed by evacuation of the uterus.

Please report to your Obstetrician ASAP with the saved pads for his inspection.

I hope this guides about your further steps. Even if you loose this pregnancy, please do not loose your heart. You stand a good chance to have a normal pregnancy to give you a bonny baby next time.

Dr. Nishikant Shrotri
Answered: Sun, 17 Jan 2016
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